Harmony Public Schools

Background Check Consent Form

Authorization for Background Investigation

Please read and complete all sections of this form carefully.

Background Check Consent Form

Please fill out the form carefully and completely.

Applicant Information

First Name

Middle Name (Optional)

Last Name

Other Names Used (e.g., maiden name)

Date of Birth

Social Security Number

Driver's License Number

Issuing State

Driver's License Photo

Upload a clear image of your driver's license.

Upload Image

Address and District Information

Street Address

City

State

ZIP Code

District

Disclosure and Authorization

I hereby authorize Harmony Inc. ("the Company") or its authorized agents to make an independent investigation of my background, references, character, past employment, education, credit history, criminal or police records, and motor vehicle reports. I release the Company and its agents from all liability for any damages that may result from this investigation.

I acknowledge that I have received the Consumer Report/Investigative Consumer Report Disclosure and a summary of my rights under the Fair Credit Reporting Act (FCRA). I understand that I have the right to request additional information about the nature and scope of any investigative consumer report.

I acknowledge receipt of the Consumer Report/Investigative Consumer Report Disclosure.

I authorize this background check and agree to the terms outlined above.

Signature

Typing your full name constitutes a legal signature.

Date